Time for NDIS to fix what isn't working

Former NDIS director Martin Laverty says Shorten’s newly-announced review must focus on three key areas. 

The NDIS was established by the voices of people with disability.

A plan of economist Bruce Bonyhady and actuary John Walsh to extend social insurance to people with disabilities became owned by a grass roots movement of the people the NDIS serves.

Overwhelmingly, the NDIS is a stunning success. Consider three separate measures.

The first is the NDIS set out to fulfil the United Nations Convention on the Rights of Persons with Disabilities by providing reasonable and necessary funding for people with disabilities to access support to achieve having choice and control of their lives.

The NDIS Quarterly Report at June 30 said 76 per cent of NDIS participants after their plans were reviewed believed the scheme was allowing them this fundamental human right of autonomy and self-determination.

The second is the NDIS expanded national disability support to what had been a fragmented and failing State and Territory system. As at 30 June, 313,971 people who had previously missed out on access to a support had been able to access the NDIS.

The third is that across just about every piece of data collected on social, education, employment and health outcomes for NDIS participants, the trend since the scheme started in 2013 is on the upward trajectory. Data shows the NDIS has improved hundreds of thousands of lives.

Every Australian should be rightly proud of the NDIS. It exists for any Australian if significant and permanent disability becomes part of their lives.

Yet the NDIS is not working for everyone. Many within the grass roots movement that created the NDIS have lost faith.

The Albanese government, as successor to the Gillard government that established the NDIS, has rightly now committed to root and branch review of the too-important-to-fail scheme.

Optimism that the scheme’s founding Minister, Bill Shorten, will steer through scheme improvements is lifting hopes.

Not wanting to unreasonably verbal those now conducting the review, they could do worse than address three immediate priorities.

First, interaction with the scheme must be made simpler. NDIS access is not needed for everyone seeking entry to the scheme, but for those with significant and permanent support needs, entry and ongoing access can be more customer centric and less red tape intensive.

The inclusion of psychosocial disability within the scheme continues to be challenging for participants, as they bounce between the health, social service and disability sectors. Entry, exit and effectiveness of the early childhood intervention pathways also needs reconsidering.

Second, the market principles underpinning the insurance scheme are resulting in pockets of market failure. Be it inadequate service provision in remote, rural and regional areas, the NDIS eligible 1,000 people in hospital or 2,500 in aged care, the service ecosystem is fragile and needs bolstering.

Third, safety and quality are not consistent for all NDIS participants. Every provider should be registered, for both safety and fraud protection. Pricing should be set by an independent body, with determinations published to detail how safety and quality standards are funded.

Simplifying scheme access, addressing market failure and providing for safety and quality in service provision are the building blocks the review can prioritise. People with disabilities, and the service providers who support them, are ready to help co-design solutions to these problems.

The review will also need help to tackle even bigger challenges.

The carer labour market is the tightest it’s ever been. Childcare, aged care, health care and disability care are competing with each other for staff. Quality of services is dependent on great carers. There is no easy fix, and pledged expanded migration will help.

Challenges in employment of care givers is only part of the equation. As an insurance scheme, the NDIS has a goal of expanded employment of people with disabilities.

There are stunning success stories of the NDIS getting people into their first ever jobs. Yet we need more employers willing to create work environments where employment with a disability becomes normal.

Finally, the NDIS aspires to innovation in the way people with disabilities are supported. Innovation has not occurred at the pace so many hoped for, particularly in housing. Supported Independent Living and Specialist Disability Housing is ripe for users and expert thinkers alike to reassess.

With the NDIS almost a decade old, this major review comes at the right time. Those of us involved in getting the NDIS up and running often felt much was rushed. Now is a chance to draw breath and adapt the scheme for it to fulfil its choice and control human rights objectives.